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Issued [3y wntw <br />Issued Deparlment Pw <br />Dale Issued enanooa <br />Fund ao� <br />Program <br />-� s �: ti � � <br />���r p� <br />Work Activity Work Order <br />WARD, MICHAEL W. <br />PUBLIC WORKS <br />Accounts Program �to Funclion �t� <br />3 <br />E�ag� i <br />�i�izo��e io:z� <br />ACllvlly 675 <br />TItl2 REPAIR 401 SW EVERC-TT MALL WAY 710119675 <br />Work Order No 20�8�5�9 PfOJOCI ACIIVIIy Ty�6 CORRECTIVE MAINTENANCE <br />Date sizs�zooe Time orza Original WO 8illing <br />Cus[omer Information <br />Customer Name <br />Address <br />Aparlmenl No <br />Slale <br />Subdivision <br />Phone No ( 1 - <br />Second Phone ( 1 - <br />E•Mail Address <br />Problem Information <br />Address 401 <br />From Cross Street <br />To Cross Street <br />Cily <br />Subdivision <br />Problem <br />Sub Problem <br />Reques�ed By <br />Agency <br />Initiated From <br />Utility Locate (USA) No <br />Assignment Information <br />Dept <br />Crew <br />Contractor <br />Assigned To <br />Assigned By <br />Assigned Date To Be Comp Dale <br />Scheduled Date Scheduled Time <br />Route Route Sequence <br />Comment5 DILL TO: OIGPOOT INVESTMENT GROUP, LLC <br />21110 84TH AVt S, SUITE ii201 <br />KENi, WA 98032 ATTN: JENNIFER WHITMORE <br />ACIiOn TakCn OOX LEFT AT SITE FOR CONTRACTOR TO INSTALL <br />Customer ld <br />Sfreet <br />Cily <br />Zip <br />Ext <br />Ext <br />Street SW EVERETT MALL WAY <br />Map Book <br />Called Date <br />Change Map YIN <br />Zip <br />Map Reference <br />Date Requested <br />Related Requesl <br />Expiration Date <br />Priority Estimated Hours <br />S�BfUS CL <br />CO�il�lBted By STW STRICKLER, TO�D W. ApPfOved By <br />. _ . _ ---- ---- - — - . _ . <br />Start Date � � Time Date Compleled s�zsizooa Time <br />-- - -- <br />Job Cost Information(Y/N) Follow Up? Permit No <br />